Young Lisa E, Sacks Naomi C, Cyr Philip L, Sharma Abhishek, Dahdal David N
Ferring Pharmaceuticals Inc., Parsippany, NJ, USA.
Precision Health Economics, Boston, MA, USA.
SAGE Open Med. 2017 Aug 31;5:2050312117727999. doi: 10.1177/2050312117727999. eCollection 2017.
To evaluate outcomes of colorectal screening using sodium picosulfate and magnesium citrate compared with other prescription bowel-preparation agents. Primary endpoints were rates of procedure-associated hospitalizations, diagnosis at hospitalization, and rates of early repeat screenings.
This retrospective cohort study identified patients using the Truven Health Analytics MarketScan databases, which contain fully adjudicated, de-identified, medical- and prescription-drug claims, as well as demographic and enrollment information for individuals with commercial, Medicaid, and Medicare supplemental insurance coverage. Patients who had a colonoscopy or sigmoidoscopy over a 3-year period were identified using procedure codes, recorded on claims from physicians and facilities. First, screening colonoscopy was identified for each patient, and the study was limited to those patients who could be observed for ≥6 months before and 3 months after the screening procedure. Total number of hospitalizations and rates of early repeat screenings were evaluated for all patients who received sodium picosulfate and magnesium citrate and compared with those who received other bowel-preparation agents. Individual prescription medications that could affect the outcome of the cleansing agent were identified; further evaluations were made to establish whether patients had comorbid conditions, such as chronic kidney disease, cardiovascular disease, or psychiatric illness. Statistical methods included descriptive statistics, two-tailed -tests, and multivariate logistic regression.
A total of 566,628 procedures were identified in the MarketScan databases and included in the study. Sodium picosulfate and magnesium citrate performed well in terms of safety outcomes, with no hospitalizations due to diagnosis of hyponatremia, dehydration, or other fluid disorders in the 10 days after procedure. Early repeat rates among sodium picosulfate and magnesium citrate patients were comparable with rates observed for all other cleansing agents.
Outcomes of colorectal screening using sodium picosulfate and magnesium citrate were not significantly different compared with other prescription bowel-preparation agents.
评估使用聚乙二醇硫酸钠和枸橼酸镁进行结直肠癌筛查与其他处方肠道准备剂相比的效果。主要终点是与手术相关的住院率、住院时的诊断率以及早期重复筛查率。
这项回顾性队列研究使用Truven Health Analytics MarketScan数据库识别患者，该数据库包含经过全面裁决、去识别化的医疗和处方药索赔，以及具有商业、医疗补助和医疗保险补充保险覆盖的个人的人口统计学和注册信息。使用医生和医疗机构索赔记录中的手术代码，识别在3年期间接受结肠镜检查或乙状结肠镜检查的患者。首先，为每位患者确定筛查结肠镜检查，并且该研究仅限于那些在筛查程序前≥6个月和后3个月可观察的患者。评估所有接受聚乙二醇硫酸钠和枸橼酸镁的患者的住院总数和早期重复筛查率，并与接受其他肠道准备剂的患者进行比较。识别可能影响清洁剂效果的个体处方药；进一步评估以确定患者是否患有合并症，如慢性肾病、心血管疾病或精神疾病。统计方法包括描述性统计、双尾t检验和多变量逻辑回归。
在MarketScan数据库中总共识别出566,628例手术并纳入研究。聚乙二醇硫酸钠和枸橼酸镁在安全结果方面表现良好，术后10天内没有因低钠血症、脱水或其他液体紊乱的诊断而住院。聚乙二醇硫酸钠和枸橼酸镁患者的早期重复率与所有其他清洁剂观察到的率相当。
与其他处方肠道准备剂相比，使用聚乙二醇硫酸钠和枸橼酸镁进行结直肠癌筛查的效果没有显著差异。
